Contract performance and training conditions in family physician and referral system: the provider's perspectives

Objective (s): In 2005, Iranian Ministry of Heath, Ministry of Welfare and Medical Services Insurance Organization conducted ‘Family Physician and Referral System’ (FPRS) as a major reform in heath system. The first step of the FPRS was carried out through all rural areas and small cities with population less than 20,000. The aim of this study was to assess the providers’ (physicians and midwives) perspectives about the contracts and training conditions in this program. This was a cross-sectional study using a designed questionnaire including items on contracts and training.1780 physicians and 1772 midwifes were studied through out the country. About 60% of physicians and midwives were working in rural centers. About 62 of physicians and 72% of midwives had a print version of their contracts. About 47% of physicians and 58% of midwives indicated that that the amount of payment was similar to the contracts. Only about 20% of physicians and 32% of midwives reported that payment was timely as indicated in the contracts. About 15 percent of providers indicated that they had no training course about the FRPS. Only about 60% of physicians and 41% of midwives had a print version of the program The findings suggest that for improving ‘family physician and referral system’ and its proper continuation and expansion, improvement of contract conditions and training courses are essential.